Multi-pronged Approach to Suicide Prevention and Intervention in Singapore

NOTICE OF ADJOURNMENT MOTION
FOR THE SITTING OF PARLIAMENT ON 25 MARCH 2020

Miss Anthea Ong (Nominated MP)

WORKING TOGETHER TOWARDS A ZERO-SUICIDE SINGAPORE

Answer

“Multi-pronged Approach to Suicide Prevention and Intervention in Singapore”

1. Mr Speaker, the Ministry of Health (MOH) is committed to mental wellness and suicide prevention and to this end, Singapore adopts a multi-pronged approach.

Stats and figures to put things into perspective

2. Internationally, based on WHO’s 2016 age-standardised death rates, Singapore’s age-standardised death rates from suicide (7.9 per 100,000 resident population¹) is lower compared to not just countries like South Korea - 20.2 and Japan -14.3, but also countries like Finland and US (13.8, and 13.7 respectively). It is also lower than the annual global age-standardised suicide rate of 10.5 per 100,000 population². In Singapore, the number of suicides involving 10 to 19-year-olds fluctuated from 13 cases in 2014, 27 in 2015, 22 in 2016, falling to 12 in 2017 and rising again to 22 in 2018. The number of elderly³ suicides has declined from 126 cases in 2014 to 115 cases in 2018 despite an ageing population.

What we have been doing

3. Nonetheless, we recognise that every suicide is one death too many and we have and will continue to strengthen our strategies to prevent suicides as guided by the National Mental Health Blueprint and Community Mental Health Masterplan. Through partnering Ministries and agencies, we have adopted a multi-prong approach to suicide prevention based on the following four key strategies of (1) building mental resilience, (2) encourage help seeking and early identification, (3) supportingat-risk groups, and (4) providing crisis support. We have also invested in resources for mental health as well as put in place monitoring and tracking mechanisms to evaluate the effectiveness of our programmes.

4. As noted by Ms Ong, there are social and environmental factors that contribute to the individual’s intent to self-harm. Therefore, our strategy targets upstream protective factors in addition to strengthening downstream supportive services. Suicide prevention and intervention strategies have been developed in schools, workplaces and in the community. Let me briefly highlight our many efforts under our 4 key strategies.

(1) Building Mental Resilience

For Youths

5. As part of suicide prevention strategy, MOE has focused on upstream efforts to build students’ social and emotional skills and resilience through the school curriculum, CCAs and various programmes. The Health Promotion Board (HPB) also offers mental well-being programmes to equip students with the skills to cope with stress, overwhelming emotions, interpersonal conflicts, change and transitions.

For Adults

6. At the workplace, HPB conducts mental well-being roadshows and workshops to provide stress management tips and techniques to employees. The Ministry of Manpower (MOM)’s Workplace Safety and Health Institute, in partnership with other agencies⁴ have developed an assessment tool, iWorkHealth, as well as a website to help workers identify workplace stressors and resources to improve one’s mental well-being.

For Seniors

7. Under the National Seniors’ Health Programme, HPB organises healthy ageing workshops that include psychosocial education modules aimed at empowering our seniors aged 50 years or older with the knowledge and skills to manage their mental well-being.

(2) Early Identification and Encourage Help Seeking

Early Identification

8. Early identification and encouraging help seeking are vital for suicide prevention. Hence, we have invested in raising mental health literacy through training and education programmes. Beyond SOPs, school teachers are trained to identify students experiencing distress, provide timely support and refer students in distress to school counsellors or mental health professionals for further interventions. Peer support structures are also being established in schools and Institutes of Higher Learning (IHLs) by HPB as well as MOE.

9. The Community Health Assessment Team (CHAT) offers easy access to mental health resources and help via different avenues for young persons between 16 and 30 years old. Young persons may either visit the CHAT hub⁵, log onto CHAT’s online portal for its WebCHAT service or call CHAT’s hotline.

10. Samaritans of Singapore (SOS) and HPB conducts programmes on how to identify suicide warning signs and where to seek help.

11. The Agency of Integrated Care (AIC) has been working with community-based organisations to set up Community Outreach Teams to reach out to seniors with or who may be at risk of dementia or depression.

Addressing Stigma to Encourage Help Seeking

12. Anti-stigma efforts play an important role in encouraging persons in distress to seek help early. Hence, in 2018, the National Council of Social Service (NCSS) rolled out a multi-year public education campaign, called ‘Beyond the Label’ to achieve this objective. NCSS also recently launched the Beyond the Label Helpbot, Belle to make access to mental health information and resources⁶ in the community easier for the general public.

Decriminalisation of Suicide

13. We recognise that persons who are greatly distressed and attempt to take their own life requires help and the criminal justice system may not be the best option. As of 1 January this year, attempted suicide is no longer a crime in Singapore. However, the Government will continue to track reports of such cases. Additionally, public hospitals are working on tracking attempted suicide cases that they attend to.

(3) Support for At-risk Groups

14. There are a range of services in place to support at risk groups of all ages in our community. For instance, we have trained Silver Generation Ambassadors to identify seniors who live alone, and to proactively offer them befriending services, identify and escalate cases with mental health needs.

(4) Crisis Support

15. We also have services in place to support persons in distress who require assistance such as Institute of Mental Health (IMH)’s 24-hour mental health helpline and the Samaritans of Singapore’s (SOS) hotline which is funded by NCSS.

Moving Forward

16. I agree with Ms Anthea Ong that every life matters, and we have and will continue to strengthen our efforts. During this year’s committee of supply (COS), Ministry of Education (MOE) shared that they will feature mental health education in the revised Character and Citizenship Education (CCE) and MOH will also be setting up an Integrated Youth Service (IYS) in Woodlands this year.

17. The Ministry of Manpower (MOM) has also announced their intention to work with tripartite partners to develop a Tripartite Advisory on Mental Well-being. In addition, the Tripartite Alliance for Fair & Progressive Employment Practices (TAFEP) has recently clarified that companies should not ask for declaration of applicants’ mental health conditions unless there is a job-related requirement.

18. We have established platforms for a coordinated interagency approach to suicide prevention. For example, the Inter-Agency Research Workgroup for Youth Suicides, brings together agencies⁷  to study the issues surrounding youth suicides and to facilitate deeper collaboration between the various agencies. The workgroup will be sharing their recommendations, for agencies to follow-up later this year.

19. In February this year, more than 800 people from different walks of life responded to Minister Desmond Lee’s open call to participate in a Youth Mental Well-being network to be established. This Network brings people together to identify opportunities and gaps to work on to improve youth mental well-being.

A Whole of Society Approach is Required

20. There is no easy solution to suicide prevention as the causes are complex and multifaceted. Even as we undertake a whole of government review to enhance our efforts towards this end, a whole of society approach is necessary to build mental resilience in order to prevent suicide in Singapore.

21. Mr Deputy Speaker, even as we celebrate life, we all know too well that it can sometimes be stressful and challenging. COVID-19 for instance poses yet another huge test for all of us, not least in mental resilience. Beyond the government’s resources and support as well as the many community programmes and efforts, I urge my fellow Singaporeans to stand together, look out for each other, develop strong empathy and reach out your hand to others to uplift them. Only together, can we ensure each other’s mental well-being and resilience especially in such unprecedented times.

22. On this note, let me conclude by thanking the member for her selfless efforts to promote mental wellbeing and prevent suicides. Let me assure her and all Members of this House that the government too will not let up our efforts on this front.

[1] Source: WHO data (http://apps.who.int/gho/data/node.main.MHSUICIDEASDR?lang=en) accessed on 23 Mar 2020

[2] Source: WHO data (https://www.who.int/gho/mental_health/suicide_rates/en/) accessed on 23 Mar 2020

[3] Age 60 and above.

[4] Workplace Safety and Health Council, Institute of Mental Health, Changi General Hospital and Health Promotion Board.

[5] SCAPE (2 Orchard Link, #05-05) and is open from 12pm to 9pm on Tuesdays to Saturdays (excluding public holidays)

[6] Resources such as 24-hour helplines, counselling services, caregiver support and upcoming mental health events etc.

[7] The inter-agency research workgroup comprises of representatives from MCCY, MINDEF, MOE, MOH, MHA, MSF, HPB, HSA, IMH, NUH and the State Courts.